Electroshock Resurrected

November 17th 2008

Max Fink, M.D., is Professor of Psychiatry and Neurology Emeritus at State University of New York at Stony Brook. He is the author of Electroconvulsive Therapy: A Guide for Professionals and Their Patients, the latest guide to ECT. It carefully explains where in the course of an illness ECT is best considered, what will take place, the necessity of voluntary consent, and how the treatment works. In this post, Dr. Fink looks at why electroconvulsive therapy is making a comeback.

Soon to celebrate its 75th birthday, electroconvulsive therapy (ECT, electroshock) is undergoing world-wide revival despite its negative image. Its efficacy in treating medication treatment failures, especially in patients with melancholic depression, bipolar disorder, psychosis, and suicide risk encourages its use. It also helps that the present ECT methods are safe and that scientists have developed a better understanding of its mechanism.

Developed in the 1930s, electroshock therapy was widely used and was effective in reducing the thousands of patients hospitalized in the state asylums throughout America. The medications introduced in the 1950s curtailed usage of ECT, but as more and more patients failed to improve and “therapy resistance” became a watchword in clinical practice, interest in ECT revived.

Much has changed in the clinical practice from the treatment without anesthesia, oxygen, and muscle relaxation that mark present practice. Permanent losses of personal memories are no longer a feature of modern practice. Indeed, the treatment is widely endorsed and a review shows that it meets the standards of ethical medical care.

Many have argued that doctors should not be applying a treatment whose mechanism is unknown. The patients who respond best are those with abnormal endocrine physiology. We now understand that ECT liberates brain hormones that regulate the body functions that are abnormal—sleep, appetite, mood, thought, motor activity—and these releases are essential to effective treatment.

The limitations of medication treatments for depression, mania, and schizophrenia demonstrated in recent large scale governmental studies and the reports of efficacy of ECT support this revival. The increased interest is world-wide and has broken some national barriers that restricted the use of ECT in some countries.

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Recent Comments

Most of doctors and medical workers are wicked and terrorists, Whether they know the demerits of ECT or not but they like to force the ignorant people to this machine and force them to agree they have mental illness. The ETC may cause structural damage to underlying tissues as prolong epiletic seizures with the failure to breath during prolonged fits.There is also poor knowledges as whether long term problem are due to lost of memory or brain damage of the ECT effects.

dan19th November 2008

Despite over a half-century of use, only two comprehensive, long-term studies have ever been done formally assessing cognitive function in post-ECT patients six months or more after their “treatment.” Both of these studies documented persistent global deficits in cognition. This suggests brain damage.

And with regard to “Max Fink”, he recently in a publication suggested that the therapeutic mechanism of ECT is actually a side-tracking delirium rather than a true antidepressant response, and he compared ECT in this respect to frontal lobotomies that often left people retarded, and also insulin comas, which often left people so brain damaged that they died. To help understand what delirium is and why it is not a true antidepressant response, it is what happens when many depressed people get drunk, only the brain tends to return to normal function after drunkennes and not fully after ECT.

In addition, within the last few years a few animal studies have been published showing that ECT produces significant damage to parts of the brain, up to 15% of hippocampal brain cells in mice die after an ECT series at an intensity and duration corresponding to modern human ECT. And this number doesn’t even take into account the number of cells which are rendered dysfunctional rather than killed. The damage is too diffuse to pick up on MRI. Random cells out of the billions in the brain are blown out like circuits in a cellphone dropped in water, and a larger portion are left permanently dysfunctional.

Moreover, a new functional brain imaging study (SPECT) found that patients responding to ECT routinely show quote, “reduced brain function” and compromised regional cerebral blood flow six weeks after the procedure, while depressed patients responding to medications or other therapies show increased brain function. This more or less proves the delirium theory.

I’m listing a number of PubMed numbers below. Insert one into the search engine at pubmed dot org to pull up each study abstract.

ECT is not being resurrected. It never left. There’ve regularly been stories saying that ECT is making a comeback in the news almost every month for the last twenty years. If you don’t believe me, type “electroconvulsive” into google news once a week and watch them appear in random newspapers. Please keep in mind that psychiatrists who regularly give ECT make salaries twice or three times that of psychiatrists who do not give ECT. And most researchers also have financial ties to the ECT industry.

And more than one professional reviewer has concluded the ECT doesn’t even work for depression, as when you look at the sham ECT literature, there really isn’t any difference in response rate.

See the article on breggin.com. See section
called Blog and News and read the article
by Dr. Peter R. Breggin called “Disturbing News for Patients and Shock Doctors Alike” regarding the Dr. Harold Sackeim study on ECT which proves that ECT always causes brain damage.